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While the story as a whole is well put together, you can see how things are being introduced as they are thought up. This was originally a single short story/novella, and then the rest was done a couple years later, with two sections also published as separate short stories, though I suspect that the entire novel was coming into focus as she wrote them instead of this “fix up” novel being completely an afterthought.

The setting is a bit nebulous. At the start, we just have a desert that the main character has journeyed into to help a sick child. We get mountains and the like later. Oh, and this is post-apocalyptic Earth, with all trace of the civilization we know gone. But there are still occasional irradiated craters. This gets sprung on us very suddenly.

Not quite as sudden is the revelation that life continues off Earth. We don’t know much about it. Travel, apparently interstellar, happens. There is alien life. Whether humans have any part in that is hard to say. But Center is a terrestrial city of humans who have contact with all of this, though we don’t really get to see any of that either.

Bio-engineering and related concepts have come a long way. Snake is a healer, who has three snakes with her, and two of them are used to treat people by getting them to alter their venom to something helpful.

While the plot works it does suffer from the same sort of randomness. The initial short story is the start of the book and Snake and Arevin promise to meet up again after dealing with the aftermath of that story. But events have Snake constantly redirecting from one short-term goal to another, while looking to the same long-term one. Locally, she is in charge, but in the wider plot she is more acted upon than acting. Still, all the elements come together well for the concluding section, which is also well plotted and paced, and leaves the book on a very strong note.